Daydreamer or Whirling Dervish:

Today, ADHD (attention deficit hyperactivity disorder) is diagnosed with increasing frequency. In fact, according to the American Academy of Pediatrics, ADHD is one of the most common chronic conditions affecting children.


It is not simply a case of bad behavior. This biological disorder causes the parts of the brain that control attention and activity level to function differently. ADHD's trademarks – persistent inattention and hyperactivity – can make daily life, for the child and his or her parents, an ongoing challenge. Although it is a lifelong condition, the right support and intervention can help set a child up for success for the rest of his life.



My son can never sit still. Could he have ADHD?


Share your concern with your son's doctor and check in with his teacher who can give you feedback on what's happening at school.


A child with ADHD may have one or several of these symptoms:


  • Inattention: A hard time focusing on one thing. Easily distracted, often daydreams and finds it hard to stay organized.
  • Hyperactivity: Perpetual motion, squirmy, difficulty staying seated and may talk too much.
  • Impulsiveness: Acts and speaks without thinking, often interrupts and can't wait his turn.
  • Multiple settings: Symptoms occur in more than one setting – for example, both at home and at school.


There is no specific test such as a blood test or MRI to diagnose ADHD. A doctor talks to the child and gathers information from parents, caregivers and teachers to make a diagnosis. The child may be referred to a pediatric neurologist or psychologist for more detailed psychological testing and treatment.



What are the treatment options?


Treatment may include a long-term management plan that sets behavior goals, together with follow-up visits and monitoring. Other components are education about ADHD, involving everyone who is directly part of the child's life: parents, teachers and caregivers. Counseling may be suggested for both child and family. Behavior therapy is also available. Setting manageable goals will help your child feel successful.


Medication can help a child improve focus, be less distracted and better control his behavior. There are two main types of medication:


  • Stimulants: Amphetamine-based medications (Adderall, Concerta, Dexedrine, Focalin, Ritalin or Vyvanse) are  effective and work immediately.
  • Non-stimulants: Atomoxetine (Strattera, Intuniv and Kapvay) takes longer to work and is sometimes given together with a stimulant.


Like all medications, these treatments have both benefits and side effects.



What is the best way to support a child with ADHD?


The very first and most important step is to make sure the child doesn't feel bad about the diagnosis. Reassure her that she is just as smart as other children; her brain just works in a different way. Explain to your child that many successful people have ADHD and often bring much additional creativity and energy to projects.


There are things you can do to help a child with ADHD lead a successful and productive life, including:


  • Structure. A structured environment at home and in the classroom will enable a child to stay on task and get less distracted.
  • Go for quick sprints. Children with ADHD are like sprinters and work best in short, intense bursts. Find ways to make tasks and homework less overwhelming. Use a timer and break tasks into manageable steps.
  • Redirect. You may have to help your child refocus frequently on her homework or the task at hand.
  • Fun and games. Whenever possible, turn tasks or homework into a game, a fun challenge or a more hands-on experience, so it's easier to keep your child's attention.
  • Keep moving! Regular exercise and movement will help your child get through tasks that require concentration and focus. Individual sports, such as any of the martial arts, archery and fencing, are best. In team sports, there is often too much going on, which can be distracting for your child.



Is ADHD different in boys and girls?


Generally, girls with ADHD show more of the inattentive symptoms and are quiet daydreamers. Boys with ADHD tend to be more hyperactive, squirmy, fidgety and impulsive. These symptoms get noticed sooner, so boys are often diagnosed earlier than girls.



Is there any relationship between diet and ADHD?


There's no significant evidence that eating less sugar or avoiding food allergies, to name two commonly cited examples, has any affect on ADHD. A healthy, balanced diet and getting enough sleep and exercise on a regular basis are essential for your child to function well.


Sarah Cheyette, M.D., is a board-certified pediatric neurologist at the Palo Alto Medical Foundation's Fremont, Palo Alto and Redwood City centers. She is currently co-writing a book with Peter Johnson of Dojo USA in San Bruno, titled ADD Knockdown! The Athlete's Guide to Empower Your Life.


Advice is not intended to take the place of an exam or diagnosis by a physician.